| Objective:This study analyzed the nosocomial infection data and clinical microbiological samples from a top three hospital in Qiqihar from 2015 to 2017,aimed to understand the hospital infection status,characteristics and related influencing factors,and provide a scientific basis for the prevention and control of hospital infections.Methods:Collected patient data and nosocomial infection monitoring data for hospitalization in a top three hospital in Qiqihar from 2015 to 2017,and compare the incidence of nosocomial infections,infection sites,age and pathogenic bacteria in different years.Collected sputum,urine,blood,cerebrospinal fluid,secretions,throat swabs,stool,bronchial lavage fluid,chest and ascites,bile,exudate and other microbial specimens for culture analysis,explore the strain type and composition ratio,the resistance rate of bacteria to common antibiotics.Excel software was used to establish the database of hospitalized patients and pathogenic bacteria,and SPSS 19.0 statistical software was used for data processing and statistical analysis.Results:1.In 2015~2017,there were 111,937 patients in hospitals,and the total number of patients with nosocomial infections was 483.The incidence of nosocomial infections was 0.32%,0.39%,and 0.57%,with an average of 0.43%.The incidence of nosocomial infection increased year by year,the difference was statistically significant.2.From 2015 to 2017,the main sites of hospital infection were lower respiratory tract infections(405 cases,accounting for 83.85%),urinary tract infections(54 cases,11.18%),and surgical site infections(9 cases,accounting for 1.87%).Lower respiratory tract infections account for the first place in the composition of susceptible parts.The number of cases of lower respiratory tract infections and urinary tract infections is increasing.3.In 2015~2017,the number of male patients infected with nodules was more than that of female patients,175 female patients,accounting for 36.23%;308 male patients,accounting for 63.77%,the overall male infection was higher than female,but there was no statistical difference.The nosocomial infections of male patients in 2015~2017 were 0.31%,0.40%,and 0.60%,respectively.The female infection rates during 2015~2017 were 0.34%,0.37%,and 0.49%,respectively.The incidence of nosocomial infections increased year by year.4.The number of patients with nosocomial infection in 2015~2017 increased with the age of the patients,and the incidence of infection increased.The incidence of nosocomial infection was the highest among the elderly over 60 years old,which was 83.85%.There was a correlation between the ages of the patients and the difference was statistically significant.5.The incidence of nosocomial infections in the four quarters of 2015~2017 was 0.42%,0.36%,0.46% and 0.49%,respectively.The incidence of nosocomial infection was highest in the fourth quarter,but there was no statistical difference between the quarter and the incidence of nosocomial infection.6.In 2015~2017,a total of 16,833 samples were sent for examination,and a total of 8611 pathogenic bacteria were detected.The top 5 pathogens were: Chlamydia pneumoniae 21.34%,Escherichia coli 16.18%,patina Candida was 10.07%,Acinetobacter was 8.58%,and Candida was 7.22%.7.From the drug resistance of pathogenic bacteria: drugs with low resistance rate of Escherichia coli are imipenem(Tai Neng),minocycline,meropenem,amikacin,piperacillin / tazoxazole Batatan,which is most sensitive to meropenem and imipenem(Tai Neng).The drugs with lower resistance rate of Enterobacter are imipenem(Tai Neng),meropenem,amikacin,piperacillin / tazobactam,minocycline,cefoperazone / sulbactam.Among them,it is most sensitive to imipenem(Tai Neng)and meropenem.The drugs with low resistance rate of Pseudomonas aeruginosa are: polymyxin B,cefoperazone/sulbactam,amikacin,meropenem,imipenem(Tai Neng),of which polymyxin B Cefoperazone/sulbactam is most sensitive.Drugs with lower resistance rates of Klebsiella pneumoniae include: meropenem,imipenem(Tai Neng),piperacillin / tazobactam,amikacin,cefoperazone / sulbactam,minnow Cyclin,of which meropenem and imipenem(Tai Neng)are the most sensitive.The drugs with low resistance rate of Acinetobacter baumannii are minocycline and polymyxin B.Analysis of the resistance rate of Gram-positive cocci antibiotics showed that Staphylococcus is a drug with low resistance rate: vancomycin,teicoplanin,linezolid,rifampicin,cefoxitin,of which it is most sensitive to teicoplanin and linezolid.Drugs with lower resistance rate of Staphylococcus aureus are: vancomycin,teicoplanin,linezolid,cefoxitin,oxacillin,of which vancomycin,teicoplanin,and linezolid are the most sensitive.The drugs with lower resistance rate of Enterococcus are: teicoplanin,linezolid,rifampicin,vancomycin,streptomycin(high concentration),of which rifampicin,teicoplanin,linezolid Most sensitive.The most common types of multi-drug resistant bacteria in this hospital in 2015-2017 are methicillin-resistant Staphylococcus(MRS),methicillin-resistant Staphylococcus aureus(MRSA);extended-spectrum ?-lactamase bacteria;lactamase(ESBLs)Enterobacter.Conclusions:1.In 2015~2017,the incidence of nosocomial infections has increased year by year.2.In 2015~2017,the higher the patient's age,the higher the risk of nosocomial infection.3.In 2015~2017,there were more male patients than females with nosocomial infections;the incidence of nosocomial infections in the fourth quarter was higher than in other seasons.4.The most detectable pathogens in 2015~2017 were Klebsiella pneumoniae,Candida,Acinetobacter baumannii,Escherichia coli.The detection rate of drug-resistant bacteria with multiple drug resistance mechanisms is higher.The most common drug-resistant bacteria are extended-spectrum ?-lactamase-producing bacteria and methicillin-resistant Staphylococcus aureus. |
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